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Dose–response relationship between physical activity and mortality in people with non-communicable diseases: a study protocol for the systematic review and meta-analysis of cohort studies
  1. Wolfgang Geidl1,
  2. Sabrina Schlesinger2,
  3. Eriselda Mino1,
  4. Lorena Miranda1,
  5. Anna Ryan1,
  6. Katja Bartsch1,
  7. Lukas Janz1,
  8. Klaus Pfeifer1
  1. 1Department of Sport Science and Sport, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
  2. 2Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at Heinrich Heine University, Düsseldorf, Germany
  1. Correspondence to Dr Wolfgang Geidl; wolfgang.geidl{at}fau.de

Abstract

Introduction This study protocol outlines our planned systematic review and dose-response meta-analysis of postdiagnosis physical activity and mortality in people with non-communicable diseases (NCDs).

Methods and analysis This study is based on the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols. A systematic literature search will be conducted in various databases—namely, PubMed, Scopus and Web of Science—by two researchers in order to identify prospective observational studies that investigate postdiagnosis physical activity or activity-related energy expenditure and mortality in individuals with NCDs. The target population is adults (≥18 years of age) with one of the following nine NCDs: low back pain, type 2 diabetes mellitus, osteoarthritis, depressive disorder, chronic obstructive pulmonary disease, breast cancer, lung cancer, stroke or ischaemic heart disease. We will focus on all-cause mortality as the primary outcome and investigate indication-specific mortality as the secondary outcome. For each study identified as a result of the literature search, we will conduct graphical dose-response analyses of mortality as a function of activity-related energy consumption. If more than two studies are available for one disease, we will perform linear and non-linear dose-response meta-analyses for said disease using random-effects models. We will investigate the heterogeneity of the studies and publication bias. To assess the risk of bias and the quality of the included studies, we will use the Risk Of Bias In Non-randomised Studies - of Interventions tool, which is a Cochrane tool.

Ethics and dissemination This systematic review will be conducted in compliance with ethical precepts. As the systematic review is based on published studies, approval from an ethics committee is not required. The systematic review and meta-analysis will be published in a peer-reviewed journal.

PROSPERO registration number CRD42018103357

  • physical activity
  • systematic review
  • meta-analysis
  • mortality
  • non-communicable diseases
  • exercise

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors WG had the initial idea for this review; he is the guarantor of the study. WG, EM, SS, LM, AR and KP designed the study, including the development of the selection criteria, the risk of bias assessment strategy, the search strategy and the data extraction strategy. KB and LJ will monitor the screening process. AR, EM and LM will retrieve the data from the studies qualified for inclusion. SS will conduct the meta-analysis. EM, WG and SS prepared the draft of this study protocol. All authors contributed substantially to the drafting of the paper and its revisions. All authors have read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.